Symptom Management Self-Efficacy And Nursing Intervention In Senile Osteoarthritis Patients

Objective:Through the investigation of influencing factors of physical,psychological and social aspects of senile osteoarthritis(OA)patients,the level of self-efficacy and its influencing factors in elderly patients with OA were analyzed,and the nursing intervention program based on self-efficacy theory was discussed.Improve the effectiveness of symptom management in elderly OA patients.Methods:This study consists of two parts,the status survey and the empirical study.At the current investigation stage,senile OA patients treated at three grade A Hospital of Taiyuan City were investigated by using a convenient sampling method.The General Information Questionnaire for Aging Patients with Osteoarthritis,the ASES-8,NRS,SDS,WOMAC and SSRS were used as research tools to analyze the self-efficacy of OA patients and their influencing factors.In the empirical research stage,58 elderly OA patients who met the inclusion and exclusion criteria were divided into a control group and an intervention group according to their order of admission.The control group was given hospital regular nursing interventions and oral health education mode;the intervention group was given a customized nursing intervention program,including care interventions to explain illness and persuade,master skills,role models,social support.Before and after the intervention,the effects of interventions were evaluated using the ASES-8,chronic disease self-management behavior scale,NRS,WOMAC and SF-6D.SPSS19.0 statistical software was used to analyze and process the data.Statistical methods included t-test,chi-square test,correlation analysis,multiple stepwise regression analysis,and so on.Results:1.A total of 200 people completed the survey,and the overall average self-efficacy score was 4.80±0.97,which was at the mid-low level.2.The results of univariate analysis showed that age,place of residence,religious beliefs,education level,pre-retirement occupation,living conditions,monthly income,time of illness,and degree of restricted activities had statistically significant differences in the elderly OA self-efficacy score(P <0.05);However,gender and disease understanding did not have statistical significance for patients' self-efficacy scores(P>0.05).The self-efficacy of pain-related factors such as pain score,WOMAC score,depression score and social support score was statistically significant(P<0.05).3.The results of multi-factor analysis showed that the five variables of social support,education level,activity limitation,living conditions,and disease time were the main influencing factors affecting the self-efficacy of senile OA patients.The complex correlation coefficient of social support factors was 0.596,and the significance test in the regression equation was F=62.752,P<0.001,which could explain 62.75% of the self-efficacy variables.4.Before the intervention,two groups of arthritis self-efficacy scale(8 items),chronic disease self-management behavior scale,Numerical Rating Scale(NRS),the WOMAC scale and concise health questionnaire(SF – 6D)scores no statistical difference(P > 0.05);Both groups after intervention scoring in arthritis self-efficacy scale(8 items),chronic disease self-management behavior scale,WOMAC scale and concise health questionnaires were statistically significant(P < 0.05),but in the Numerical Rating Scale(NRS)has no statistical significance(P > 0.05).Conclusion:1.The level of self-efficacy of elderly patients with osteoarthritis is at a moderately low level,and health education should be conducted in a timely manner.2.The main factors affecting the self-efficacy of the elderly include: social support,education level,degree of activity restriction,living conditions,and sickness time.Among them,the level of social support is positively correlated with the level of self-efficacy of the patient.The more social support the patient receives,the higher the level of self-efficacy.It is suggested to strengthen contact with community service centers to ensure that patients receive more social support.3.The nursing intervention program based on the self-efficacy theory can improve the patients' self-efficacy,promote the active and effective management of the disease in elderly OA patients,and improve the quality of life of OA patients.